Gout: Causes, Symptoms, Diagnosis, Prevention and Treatment

Gout, a type of arthritis that can result in joint pain, swelling and redness, is caused by excess uric acid in the system. In normal circumstances, uric acid dissolves within the blood, passes through the kidneys and is then expelled via urine. Conversely, if the body produces too much uric acid or if the kidneys fail to excrete an adequate amount of uric acid, uric acid can build up to high levels. Urate crystals can then form and accumulate in joints. The result of that process is gout.

Gout attacks can also lead to more severe complications. For instance, if gout remains ongoing due to lack of treatment, it can begin to erode and possibly even destroy affected joints. Untreated gout may also result in advanced gout which can create urate crystal deposits under the skin in areas such as fingers, hands, feet, elbows and Achilles tendons. Although these urate crystal deposits don’t cause as much pain as an actual gout flare-up, they can be swollen and tender during gout attacks. People with gout can also develop urate crystals within their urinary tract, resulting in kidney stones.

So how do these high levels of uric acid accumulate? One way is that the body produces uric acid when it breaks down purines. Purines come from red meat, shellfish, seafood such as anchovies, sardines, trout and tuna, as well as alcohol and beverages containing fructose.

Aside from diets rich in purines, there are other factors which can lead to gout. Being overweight is one of them. When the body is obese, it produces more uric acid and strains to expel it adequate amounts. 

There are also medical conditions which can cause gout, including high blood pressure, diabetes, kidney disease and heart disease. Body trauma such as surgery can trigger gout attacks, as well as vaccines in certain people. Genetics can also play a significant role in the cause of gout. If there is gout in your family history, you are more likely to acquire it. 

Very common, with over 200,000 cases in the U.S. alone every year, gout is more prevalent in males and those between 35 and 50 years. However, women are more prone to gout attacks after menopause, when their uric acid levels tend to climb.

Lasting from just a few days to several weeks, the pain associated with gout can be so jarring that it can wake a person out of a dead sleep with the sensation of the affected joint or joints being on fire. This intense joint pain usually occurs at the base of the big toe, although it can occur in any joint. Other joints commonly affected are fingers, wrists, elbows, knees and ankles. Affected joints can become tender, inflamed and red. Gout pain is usually more severe at the onset of the attack and then it commonly morphs into lingering discomfort. Subsequent gout attacks tend to last longer and affect more joints within the body. 

Gout pain can become so debilitating that it limits range of motion and can affect activities of daily living including the ease with which you walk, drive, operate a computer or phone, dress yourself, etc. Left untreated, it can lead to worsening pain and even joint damage. 

Therefore, it is a good idea to seek medical attention if you think you may be suffering from a gout attack. Immediate medical attention should be sought if a fever or hot, inflamed joints are present, indicating infection.

In order to properly diagnose gout, your doctor may perform a variety of tests after a physical examination of the affected area and gathering information such as family and medical history. These may include blood tests, which are recommended for measuring uric acid levels within the blood. 

However, since some people may have high levels of uric acid in their blood without ever experiencing gout, a joint fluid test can become important in gout diagnosis. A joint fluid test is when a needle is used to extract the fluid around the affected joint to test it for urate crystals.

An ultrasound may be used to detect the presence of urate crystals and an x-ray of the affected joints may be effective in helping to rule out other possible causes of joint inflammation. Additionally, a dual energy computerized tomography (DECT) may be used to show urate crystals from a multitude of x-ray angles.

Although there is no known cure for gout, lifestyle choices such as healthier beverage options, avoidance of foods that are high in purines, and optimal body weight maintenance can help reduce your chances of a gout attack.

There are also medications for both the treatment of gout attacks and the prevention of gout complications. Medication used to treat the pain and inflammation of gout attacks include over the counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, Aleve; as well as stronger prescription NSAIDs like colchicine which is another anti-inflammatory medicine also used to reduce pain, as are corticosteroids which can be taken in pill form or injected directly into the affected joint.

Medications which actually work toward lowering uric acid include drugs such as allopurinol and febuxostat, which help limit the body’s uric acid production; and drugs such as probenecid, which aids the kidney in uric acid elimination.

Riverside Clinical Research is currently scheduling volunteers for gout clinical trials. If you would like to see if you qualify to participate in a Riverside Clinical Research gout study, you can call Riverside Clinical Research for more information at 386-428-7730 Monday through Thursday from 7 a.m. to 5 p.m. or Friday from 7 a.m. to 12 p.m. You can also learn more about the clinical research trials at Riverside Clinical Research by accessing our patient portal which can be found on our website or by emailing your questions to info@riversideclinicalresearch.com.

Riverside Clinical Research volunteers are paid for their time, there are no costs for the medical procedures or treatments provided and there is no insurance necessary to participate. The medical professionals at the Riverside Clinical Research facility work closely with clinical trial volunteers to monitor and assess the benefits and effectiveness of certain treatments. Riverside Clinical Research is conveniently located at 1410 S. Ridgewood Avenue in Edgewater.